Psa Activity Readiness Questia PRD = (ised 2002) ‘(A Questionnaire for People Aged 15 to 69) ‘Regu ysl scty un an heaty, and ines oe cl ae tring te beam mo cine ry dy Beng mae achive vy safe fer most pene Hoe, soe people soul check wie itr bere they iat bing mech ware pascal ace {you planing to bzone noch nr physaly ate than you aw, tty answering te seen quests nie bobo. yay betwen the agesct Sond, the PAR 0 ‘leon fo inl check wth yu cir etry srt yc are oer Byers of age, andy ae a sed eigen acre chek wth pur dct: ‘Corn ease yout st ule when a answers qustans Pasa adhe quis carly andansnet ach na hatesth check YES WD. ‘SB. 1. steer dcr ever sad tt youve a feat anion nat yo shld ond pyc act reamed by ack? OG mmpkerpn parce hep se psc sce C3. Inthe past month, have you had chest pain when you were nat doing physical activity? EB doyle yarnnes ence of aes oye ie coconses? oos eet a He) coe amr acianee yur ose acorn? Ea It A paaweeem YES to one or more questions Tatty cry phone in person BEFORE tat acing mach re scaly active BEFORE oa hae 2 ess appraisal Telly dct atthe PAP ard which usin you answered YES, ‘+ Younay be alta de any acy you wart —as eg as ou sa sty 2 bul up racualy, Or, jou mayne trate or acts thse ich | ‘ste fry Takhar dtr abate ks of aches ou wish pare in and flew hse aie. {dt hich communi reas safe ne ay DELAY BECOMING MUCH NORE ACTIVE ya ot fing wel becasect a empray ies sick 25d re eer wait nt you el betes 0 «yeu ae may pregnant tao yor dt bee st beaming me ate NO to all questions yas answered NO ues al PHD ues, jou con be masa sure tha yon * Stat boring much mow pyscally ectve— bein sonar ui up ered, Ths the safest and east mayo. takepart ines aporaal iss an ocelot way etemine yu basics otis ou can Han the best way eyo toe ache. is also high recemmenced tha jouhave your bed press ‘uated. your easing is vr 14954, ah withyour dcr bee tat becaningimch ne Physical ace. ‘ou Use of te P The Cnatan Sse erie Physio Heath Canada athe eget assume Haier pers wo underaephyscal acy acim dot ater compen this usta const yur dar pro hel acy. ‘No changes permitted, You are encouraged to photocopy the PAR-Obut only if you use the entire form. NTE tthe PAR-Qis being pve person eee or she parties in a physical ay rogram anes appraisal his seton maybe use regal cr adnate purses. “Thave read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.” NAME: PLEASE NOTE: your heat changes otha youth asm YESIo aylthe above qari el yours: al posinal Ak ete yu shad change or physical acy pian SIGNATURE OF PARENT wrness ‘or GUARDIAN (or participants under the age of majority) oe Ts yeaa loc ala au of 2 ons one a erp neces nal culo chanpso bala wel ane YES aol ase to Be ©caotin Sait bere Psistey Sopotedy HH S22. E, cotiwed on otter sife Pl eat ay Cana dite Cdn Se Eee yy, peeps fe Cann Sey Ese Pye SOURCE: aya Acty exis Gunnar PAR ) © 20. Ud wt parassn Fo te Cosco tity fer are Pre, wrwsenc